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Browsing by Author "Holden, Richard J."
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Item Activity Theory Analysis of Heart Failure Self-Care(Taylor & Francis, 2018) Cornet, Victor; Voida, Stephen; Holden, Richard J.; Medicine, School of MedicineThe management of chronic health conditions such as heart failure is a complex process emerging from the activity of a network of individuals and artifacts. This article presents an Activity Theory-based secondary analysis of data from a geriatric heart failure management study. Twenty-one patients' interviews and clinic visit observations were analyzed to uncover eight configurations of roles and activities involving patients, clinicians, and others in the sociotechnical network. For each configuration or activity pattern, we identify points of tension and propose guidelines for developing interventions for future computer-supported healthcare systems.Item Advocacy in Mental Health Social Interactions on Public Social Media(2022-02) Cornet, Victor P.; Holden, Richard J.; Bolchini, Davide; Brady, Erin; Mohler, George; Hong, Michin; Lee, SangwonHealth advocacy is a social phenomenon in which individuals and collectives attempt to raise awareness and change opinions and policies about health-related causes. Mental health advocacy is health advocacy to advance treatment, rights, and recognition of people living with a mental health condition. The Internet is reshaping how mental health advocacy is performed on a global scale, by facilitating and broadening the reach of advocacy activities, but also giving more room for opposing mental health advocacy. Another factor contributing to mental health advocacy lies in the cultural underpinnings of mental health in different societies; East Asian countries like South Korea have higher stigma attached to mental health compared to Western countries like the US. This study examines interactions about schizophrenia, a specific mental health diagnosis, on public social media (Facebook, Instagram, and Twitter) in two different languages, English and Korean, to determine how mental health advocacy and its opposition are expressed on social media. After delineation of a set of keywords for retrieval of content about schizophrenia, three months’ worth of social media posts were collected; a subset of these posts was then analyzed qualitatively using constant comparing with a proposed model describing online mental heath advocacy based on existing literature. Various expressions of light mental health advocacy, such as sharing facts about schizophrenia, and strong advocacy, showcasing offline engagement, were found in English posts; many of these expressions were however absent from the analyzed Korean posts that heavily featured jokes, insults, and criticisms. These findings were used to train machine learning classifiers to detect advocacy and counter-advocacy. The classifiers confirmed the predominance of counter-advocacy in Korean posts compared to important advocacy prevalence in English posts. These findings informed culturally sensitive recommendations for social media uses by mental health advocates and implications for international social media studies in human-computer interaction.Item After Visit Summary: Not an Afterthought(Sage, 2019-09) Sieferd, Edward; Mohanty, Nivedita; Holden, Richard J.; Medicine, School of MedicineThe After Visit Summary (AVS) is provided to patients after clinical visits to summarize what happened during the visit and guide future care. Despite its potential to improve shared decision-making, self-management, and communication, the design of the typical AVS is not optimized to communicate useful information in an understandable way. The AVS usability challenge is magnified in vulnerable patient populations such as those served by community health centers (CHCs). The purpose of this research was to evaluate and refine a redesigned AVS intended to better communicate information to CHC patients.Item Best Practices for Health Informatician Involvement in Interprofessional Health Care Teams(Thieme, 2018-01) Holden, Richard J.; Binkheder, Samar; Patel, Jay; Viernes, Sara Helene P.; BioHealth Informatics, School of Informatics and ComputingAcademic and nonacademic health informatics (HI) professionals (informaticians) serve on interprofessional health care teams with other professionals, such as physicians, nurses, pharmacists, dentists, and nutritionists. Presently, we argue for investing greater attention to the role health informaticians play on interprofessional teams and the best practices to support this role.Item Beyond Disease: Technologies for Health Promotion(Sage, 2019-09) Holden, Richard J.; Valdez, Rupa S.; Medicine, School of MedicineHealth promotion is defined by the World Health Organization as “the process of enabling people to increase control over their health and its determinants, and thereby improve their health.” This is different from the bulk of formal healthcare processes, which are characterized by the treatment of an established disease. Much important human factors research and practice has been done to improve the healthcare delivery process and increasingly human factors professionals are also involved in work on health promotion. Such work has included examining the use and usability of wearable fitness tracking devices, studies of online health information seeking by healthy individuals, and human factors research on social robots for older adults, to name but a few examples. We discuss human factors applications in health promotion, focusing on examples from technology-related research.Item Community-Based Service Providers’ Experiences With Activities for Persons With Dementia(Sage, 2021-10) Holden, Richard J.; Cavalcanti, Luiz H.; Vemireddy, Sravani; Bateman, Daniel R.; Sheetz, Nicole; Fowler, Nicole R.; Parmar, Takshak; Karanam, Yamini L. P.; Medicine, School of MedicinePersons with dementia (PWD) benefit from participating in meaningful activities. This study’s objective was to learn the characteristics of successful meaningful activities from community-based service providers who work with PWD. Six group interviews were performed with 15 unique professionals from an adult day service or community-based coordinated care program. These were supplemented by 100 hr of researcher immersion through weekly volunteering. Data were analyzed by a team, using qualitative content analysis. Participants reported successful activity content incorporated personalization; continuity and incremental challenges; and social engagement. Successful delivery of activities required managing necessary resources; involving informal (family/friend) caregivers; having a backup plan; monitoring time of day and energy levels; facilitating a domino effect; and ensuring safety. Outcomes of successful activities were experiencing fulfillment and purpose; overcoming challenges; and unexpected triggers. Research and practice recommendations include testing innovative, dynamic, and technology-enabled approaches to providing such activities.Item Consumer Health Informatics: Empowering Healthy-Lifestyle-Seekers Through mHealth(Elsevier, 2016) Faiola, Anthony; Holden, Richard J.; Department of Biohealth Informatics, School of Informatics and ComputingPeople are at risk from noncommunicable diseases (NCD) and poor health habits, with interventions like medications and surgery carrying further risk of adverse effects. This paper addresses ways people are increasingly moving to healthy living medicine (HLM) to mitigate such health threats. HLM-seekers increasingly leverage mobile technologies that enable control of personal health information, collaboration with clinicians/other agents to establish healthy living practices. For example, outcomes from consumer health informatics research include empowering users to take charge of their health through active participation in decision-making about healthcare delivery. Because the success of health technology depends on its alignment/integration with a person's sociotechnical system, we introduce SEIPS 2.0 as a useful conceptual model and analytic tool. SEIPS 2.0 approaches human work (i.e., life's effortful activities) within the complexity of the design and implementation of mHealth technologies and their potential to emerge as consumer-facing NLM products that support NCDs like diabetes.Item Data collection challenges in community settings: Insights from two field studies of patients with chronic disease(Springer, 2015-05) Holden, Richard J.; McDougald Scott, Amanda M.; Hoonakker, Peter L.T.; Hundt, Ann S.; Carayon, Pascale; Department of Biohealth Informatics, School of Informatics and ComputingPurpose Collecting information about health and disease directly from patients can be fruitfully accomplished using contextual approaches, ones that combine more and less structured methods in home and community settings. This paper's purpose is to describe and illustrate a framework of the challenges of contextual data collection. Methods A framework is presented based on prior work in community-based participatory research and organizational science, comprised of ten types of challenges across four broader categories. Illustrations of challenges and suggestions for addressing them are drawn from two mixed-method, contextual studies of patients with chronic disease in two regions of the US. Results The first major category of challenges was concerned with the researcher-participant partnership, for example, the initial lack of mutual trust and understanding between researchers, patients, and family members. The second category concerned patient characteristics such as cognitive limitations and a busy personal schedule that created barriers to successful data collection. The third concerned research logistics and procedures such as recruitment, travel distances, and compensation. The fourth concerned scientific quality and interpretation, including issues of validity, reliability, and combining data from multiple sources. The two illustrative studies faced both common and diverse research challenges and used many different strategies to address them. Conclusion Collecting less structured data from patients and others in the community is potentially very productive but requires the anticipation, avoidance, or negotiation of various challenges. Future work is necessary to better understand these challenges across different methods and settings, as well as to test and identify strategies to address them.Item Delivering Food Resources and Kitchen Skills (FoRKS) to Adults with Food Insecurity and Hypertension: A Pilot Study(MDPI, 2023-03-17) Rivera, Rebecca L.; Adams, Mariah; Dawkins, Emily; Carter, Amy; Zhang, Xuan; Tu, Wanzhu; Peña, Armando; Holden, Richard J.; Clark, Daniel O.; Medicine, School of MedicineFood insecurity affects nearly 50 million Americans and is linked to cardiovascular disease risk factors and health disparities. The purpose of this single-arm pilot study was to determine the feasibility of a 16-week dietitian-led lifestyle intervention to concurrently address food access, nutrition literacy, cooking skills, and hypertension among safety-net primary care adult patients. The Food Resources and Kitchen Skills (FoRKS) intervention provided nutrition education and support for hypertension self-management, group kitchen skills and cooking classes from a health center teaching kitchen, medically tailored home-delivered meals and meal kits, and a kitchen toolkit. Feasibility and process measures included class attendance rates and satisfaction and social support and self-efficacy toward healthy food behaviors. Outcome measures included food security, blood pressure, diet quality, and weight. Participants (n = 13) were on average {mean (SD)} aged 58.9 ± 4.5 years, 10 were female, and 12 were Black or African American. Attendance averaged 19 of 22 (87.1%) classes and satisfaction was rated as high. Food self-efficacy and food security improved, and blood pressure and weight declined. FoRKS is a promising intervention that warrants further evaluation for its potential to reduce cardiovascular disease risk factors among adults with food insecurity and hypertension.Item Developing the Agile Implementation Playbook for Integrating Evidence-Based Health Care Services into Clinical Practice(Wolters Kluwer, 2018-10) Boustani, Malaz A.; van der Marck, Marjolein A.; Adams, Nadia; Azar, Jose M.; Holden, Richard J.; Vollmar, Horst C.; Wang, Sophia; Williams, Christopher; Alder, Catherine; Suarez, Shelley; Khan, Babar; Zarzaur, Ben; Fowler, Nicole R.; Overley, Ashley; Solid, Craig A.; Gatmaitan, Alfonso; Medicine, School of MedicineProblem: Despite the more than $32 billion the National Institutes of Health has invested annually, evidence-based health care services are not reliably implemented, sustained, or distributed in health care delivery organizations, resulting in suboptimal care and patient harm. New organizational approaches and frameworks that reflect the complex nature of health care systems are needed to achieve this goal. Approach: To guide the implementation of evidence-based health care services at their institution, the authors used a number of behavioral theories and frameworks to develop the Agile Implementation (AI) Playbook, which was finalized in 2015. The AI Playbook leverages these theories in an integrated approach to selecting an evidence-based health care service to meet a specific opportunity, rapidly implementing the service, evaluating its fidelity and impact, and sustaining and scaling up the service across health care delivery organizations. The AI Playbook includes an interconnected eight-step cycle: (1) identify opportunities; (2) identify evidence-based health care services; (3) develop evaluation and termination plans; (4) assemble a team to develop a minimally viable service; (5) perform implementation sprints; (6) monitor implementation performance; (7) monitor whole system performance; and (8) develop a minimally standardized operating procedure. Outcomes: The AI Playbook has helped to improve care and clinical outcomes for intensive care unit survivors and is being used to train clinicians and scientists in AI to be quality improvement advisors. Next Steps: The authors plan to continue disseminating the details of the AI Playbook and illustrating how health care delivery organizations can successfully leverage it.